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APPLYING THE DIAGNOSTIC SCANNER "T-SCAN" TO ANALYZE THE OCCLUSION RELATIONSHIPS OF THE DENTITIONS IN THE PROSTHODONTIST'S PRACTICE
Bulycheva D. S.,
The scientific supervisor - d. m. s, prof. Bulycheva Ye. A.
Russian Federation, city of Saint-Petersburg, The First Saint-Petersburg State Medical University after academician I.P. Pavlov
Abstract. To study the occlusial relations dentists usually use the articulating paper. But more and more professional stomatologists are inclined to deny its precision. Articulating paper doesn't show the contact force, the sequence of contact appearance in time, but it shows only the contact areas of occlusial surface of opposing teeth.
The relevance of monitoring the dental occlusion fuels the interest of manufactures and practician dentists to create the latest techniques and machines. "T-scan" (USA) is one of such apparatus. With this computer device it's possible to understand and monitor the function of teeth in a dynamic occlusion that is the data about the contact force and the sequence of its appearance.
Keywords: occlusion, occlusial relations, dynamic occlusion, computer device "T-scan", articulating paper.
For many years to study the occlusion relationships in the dentist's arsenal there has been only one device and it is considered to be quite reliable that is articulating paper. But in many works this statement is disproved (Lebedenko I.Y. 2003, Antonik M.M., Stupnikov A.A., 2003, Trezubov V.N. 2008, Peregudov A.B., Ordjonikidze R.Z., 2008, Mamedova L.A., Osipov A.V., Smotrova A.B., 2010, Bulycheva Y.A. 2010, Fadeev R.A. 2012, Rozov R.A. 2014, Kerstein R.B., 2002, 2008; Krasteva Krasimira, 1999, Makofsky H.W., 2000).
The topicality of monitoring the dentures occlusion fuels the interest of manufactures and practicing dentists to create the latest techniques and apparatuses one of which is "T-scan" (USA). With the help of this device it is possible to receive the data about the contact force and the sequence of its appearance.
The goal of this article is to study the peculiarities of occlusion relationship of patients' dentitions.
The set tasks are to study the occlusion relationship of dentitions with the help of traditional device that is articulating paper; to analyze the occlusion relationships of the dentitions with the help of the computer appliance "T-scan"; to compare the received data with our own research results.
In practicing stomatology, as a rule, the articulating paper is used to diagnose the occlusion relationships of dentures.
At the end of 90s of the last century the German firm «Bausch» developed the technology of the consequent use of the articulating paper of different thickness and color.
The occlusion correction is supposed to use the articulating paper thickness of 200 ^m. Such articulating paper is sensitive to pressure and makes it possible to receive the exact profile of chewing pressure distribution. Low pressure at biting is reflected, according to the maker's instruction, with lighter indentations and higher pressure is reflected with darker teeth indentations.
Next the articulating paper of 20 ^m is used, which is of contrasting, in comparison to the first one, color that dyes the epicenters of the contact points providing the maximum possible reliability to detect the premature contact.
It is necessary to give a thorough examination of the colored contact points if in the center a light spot is observed which is of dot size and edged with dark colorful circle because it is considered the true spot of premature contact of the occlusion surfaces.
The end of the occlusion correction is considered the existence of numerous equally distributed occlusion contacts of the dentures.
However, this technology allows only finding the contacting occlusion dots and defining with low probability by the fact of the «crushed» teeth indentations the premature contact. Moreover the articulating paper cannot show the sequence of time-bound contact appearance.
The computer device "T-scan" has opened new possibilities.
The system "T-scan" allows receiving the data about the teeth pressuring force during some period of time that can be compared to the time of saliva swallowing. The record in the system "T-
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scan" is like the video record. The principle of the device work is the following: the patient shuts their mouth to the fast fissure-tubercle contact, correspondingly, bites the sensor that is attached to the computer where with the help of the software the data analysis of the occlusion contacts, the effort and appearance sequence in time is done.
The record can be seen in two-dimension and three-dimension image that is a graphic image of the teeth arch.
The occlusion effort is reflected in a color coding from blue (the lightest contact) to red (the strongest contact).
It is considered normal the combination of the following parameters:
1) absence on the occlusion-gram of the red contacts;
2) numerous blue contacts equally distributed along all teeth arch;
3) absence of significant difference of the force value between the numerous blue contacts and some contacts of different (not red) color.
The group of 10 patients among which there were 3 men and 7 women at the age-range to 35 years was examined in the prosthetic dentistry clinic.
This group of volunteers was necessary for a quality comparison of the occlusion tooth indentations received form the articulation paper and the results received form the computer examination with the device "T-scan". The identical by their topography occlusion contacts were evaluated.
The photos of the occlusion indentations received with the help of the articulating paper were divided into 5 groups: the «crushed» contact, the intensively colored contact, the contact with a nonintensive coloring, a slight trace of the articulating paper and absence of the articulating paper trace.
The occlusion contacts of the computer occlusion-gram were systemized by the symbolically color identification of the operating system of the device "T-scan" from blue (the lightest contact) to red (the strongest contact).
In all 169 occlusion indentations were researched and analyzed and compared to the computer sensor data results. To analyze and data comparison the research protocols were made for every patient. The comparison results lead us to the conclusion that it is impossible to speak about the exact correspondence of the studied indentations.
Conclusions. As it can be seen from the received results, the «crushed» contact on the articulating paper only in 43,3 % coincides with the color code of the computer sensor (red + orange color), and in 16,6% cases is identified as normal occlusion effort. The intensively colored contacts reflecting according to the instruction of the paper maker the stronger contacts only in 29,7% correspond to the computer sensor data (green + yellow color). The contacts of the non-intensive color reflecting the physical effort only in 59,6% cases are supported by the computer analysis, and in 40,4% they are identified as stronger than physical load force even to the premature contacts. Even a slight indentation of the articulating paper in 7,1% cases is identified by the computer sensor as a premature contact.
Roughly summing up the received results we can draw a conclusion that practically every other contact reflecting by the articulation paper is not proved by the computer sensor analyses.
Thus, we have proved that it is not enough to use only articulating paper to diagnose the occlusion relationships of the dentitions.
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